Applying the ICF-CY to Specialist Speech-Language Pathologists’ Practice With Toddlers With Cleft Palate Speech

Abstract

Objective: To evaluate how the practice of specialist speech-language pathologists (SLPs) working with young children with cleft palate ± cleft lip (CP±L) maps onto the International Classification of Functioning, Disability, and Health – Children and Youth version (ICF-CY) and consider the functionality of the categories of the ICF-CY for this specialist area of practice. Design: Cross-sectional, qualitative study. Setting: Semistructured face-to-face interviews were conducted with SLPs working in tertiary-level hospitals, universities, and public clinics. Participants: Six specialist SLPs with 17 to 39 years of experience working with young children with CP±L as researchers and clinicians in Australia, Brazil, Denmark, Ireland, New Zealand, and the United States. Main Outcome Measure(s): Specialists’ practices were captured using in-depth, semistructured interviews. Data collected were analyzed by directed content analysis applying the ICF-CY as a coding schema. Results: In total, 4077 data points were coded. Most mapped onto Body Structures (684, 16.8%), Body Functions (906, 22.2%), and Environmental Factors (1626, 39.9%) with less emphasis on Activities and Participation (560, 13.7%). A “best fit” approach was taken to topics that did not map exactly onto categories of the ICF-CY (eg, velopharyngeal insufficiency [VPI]); however, there was not always an ideally suitable category available. Conclusions: The current study revealed strengths and challenges in categorizing practice within the ICF-CY for children with CP±L, including collaboration with parents and significant others, specificity around speech, language, and articulation, and the different types of VPI. Therefore, future discussion around how best to use the framework with children with CP±L is needed.

Speech Telepractice and Treatment Intensity in a Cantonese-Speaking Case with 22q11.2 Deletion Syndrome Following Late Diagnosis and Management of Velopharyngeal Dysfunction

“…The treatment pathway for this case is by no means complete and she will require further and ongoing speech treatment to reach this longterm goal. It is also essential that speech goals address communicative participation and the impact of environmental factors, [47][48][49] particularly relevant as social communication and pragmatic difficulties are often associated with 22q11.2DS. 5,14 Unfortunately, we are only able to provide clinical data and evidence of treatment efficacy and outcomes at a single word level as the case was no longer available for treatment having moved to another country.…”

An Exploratory Study of Speech and Language Therapy Intervention for Children Born With Cleft Palate ± Lip

“…(2018). Cronin et al. (2020) reported “physical geography/population density” was an important consideration for speech–language pathology practice when working with children with CP ± L.…”

“…Child Talk found that SLTs individualize therapy, often using the phrase “it depends” to illustrate how intervention management is influenced by various factors (Roulstone et al, 2015; Morgan et al, 2019). Some of these factors have been discussed in the paper by Furlong et al (2018, pp1135); namely, “child factors (eg, age, severity of communication disorder), family factors (eg, cultural differences, engagement and attendance), and contextual factors (eg, staffing pressures, access to published programs).” “Environmental factors” were also discussed in the study by Cronin et al (2020) which reported on interviews with specialist SLTs who work with toddlers with CP ± L.…”